Kudjip 2012

I think Bill mentioned in yesterday’s update that I spent yesterday (Thursday) morning doing rounds and shadowing a family practice doctor here at Kudjip. We’d had supper the night before with his wife and him and he asked if I’d like to go on rounds with him and see if there might be patients I might be able to help as an OT. I was a little hesitant since my background is in developmental disabilities and not acute medical problems. Bill encouraged me to see what kind of diagnoses there are and since we plan to return next year, I might do some research on some of the more common admissions. Little did I realize what the morning would bring when we entered Dr. Andy’s side of the Pediatrics Ward. What an introduction to the reality of medical missions.

I knew, as most people know, that it is common that people coming to mission hospitals come as a last resort generally so when they come they are very sick. I knew it, but experiencing it first-hand is quite another thing. It began in a rather light hearted way as he had a few patients in the adult outpatient department who had some chronic problems for which he prescribed various medications. We next moved to the Pediatric ward with a child of around 11 months who had been admitted for pneumonia. His labs and vitals suggested improvement but the 2 different pulse oximeters had a good 20 point spread from one to the other in the oxygen reading. It was decided to believe the higher reading with the promise to the mom that if he kept improving, he’d probably be discharged the next day. Then there was a baby under a year old with a “mystery” rash with a developing weakness. He was going to need some more observation and treatment.

We then moved on to a one month old who was septic (a serious infection that can result in death.) In the US I’m sure this baby would have been in a NICU (intensive care for newborns). She was obviously struggling to breathe, she had swelling of her entire body, had not wet her diaper in a while (a day or more- hard to know for sure) and was hardly responsive even to pain. Seeing how grave the situation was, I began praying for her, the doctor as he worked on her, and the family. As I did, tears came to my eyes. There are no curtains around the beds and most eyes follow the Dr as he assesses each child. The eyes also follow the “whiteskins” so I kept telling myself that I needed to hold it together so I wouldn’t alarm the baby’s family or the other families.

The doctors did what they could and moved on to the other patients. I marveled how Dr. Andy was able to break the tension with appropriate humor with the next little one’s family- and many in the ward chuckled .That little guy needed a spinal tap- which he commented to me he has had to perform quite commonly here. Meningitis, TB of the central nervous system, malaria and sometimes typhoid are possible causes of headache, fever, lethargy with disorientation and sometimes seizures. Through labs, tests and clinical observations, each of these most common diagnoses has to be ruled out before considering less likely causes. We finished the Pedsdept with a baby with malnutrition who also looked to my lay eyes in a pretty delicate state.

We next moved to the ER where he saw two young children with abscesses –one on the forehead and one on the foot- which he opened and drained after sedating them. There was another spinal tap, another child with probable pneumonia and an ultrasound exam on a man which, after a comment from the Dr. Andy, made me think there was a strong suspicion of HIV. While waiting for the sedation on one of the children to take effect, he was called back to Peds for what we all feared would happen- the month old baby went into “arrest”. My heart sank as I stayed in the ER with the just sedated child. When he returned 10 minutes later, he shared that the little baby had died. It was now lunchtime. Dr. Andy offered to let me shadow him some more after lunch but I thought that was enough for one day for me. There was some laundry to do, lunch to clean up and some processing to take place.

Last night was the prayer meeting for the station. Dr. Andy played a song for us which he said had been ministering to him lately- the gist was “I’ll go where You want me to go, Lord (and do what You want me to do).” I had wondered how he does it day after day for 11 years now and that song answered my question. He had obeyed the Lord’s call and no doubt relies on Him for strength throughout the day. He shared last night about a patient in the ER the other night. He had been in a lot of fights and that night Dr. Andy was setting his fractured arm. The man was sedated and he said he usually discounts anything spoken while in that condition. But that night the man asked him to pray for him. So he did – more to humor him than believing the man really meant what he was saying. He then asked the man if he wanted to pray to ask Jesus to be his Savior and he did, so Dr. Andy led him in prayer to ask Jesus into his life. He then asked the sedated man “do you know what you just did?” Yes was the answer. “Are you sure.” He asked again. He assured him he was sure. A week later the man returned for a check and was asked if he remembered what he did. He assured Dr. Andy he was a new man.

To the questions “Why are we so involved in supporting medical missions?” Yesterday’s events and conversations only confirmed in my mind and heart the answer to that question. Helping to give doctors effective tools for diagnosis and treatment and helping them preserve them through more consistent and cheaper power give opportunity to make much of God.